The spectrum of heart disease among adults at the Bamenda Regional Hospital, North west Cameroon: a semi urban setting

Pattern of cardiovascular diseases at a teaching hospital in Addis Ababa, Ethiopia: An echocardiographic study of 1500 patients

Cardiovascular diseases (CVD) represent a significant global health problem. They account for nearly one third of deaths worldwide. With improvements in diagnostic modalities, their prevalence in sub-Saharan Africa (SSA) is rising. Disease pattens vary in different regions and communities and the pattern in our setting is not known. Echocardiography is a noninvasive diagnostic tool that essential for structural and hemodynamic assessment of the heart. It stands at the far front for comprehensive evaluation of the heart because of its relative low cost and wide availability. The aim of this study was to assess pattern of CVDs among patients who had echocardiography done at a teaching Hospital in Addis Ababa, Ethiopia. A retrospective review of 1500 echocardiograms of patients referred to the echocardiography laboratory of St. Paul Hospital Millennium Medical College (SPHMMC) for cardiac evaluation from January 1, 2018 to June 30, 2019 was performed. All subjects had standard transthoracic echocardiography performed by cardiologists using General Electric Vivid E9 and E95 machines. Demographic parameters and echocardiographic findings were collected using a structured checklist from the echocardiography register. Descriptive statistics were used to assess the echocardiographic findings. The mean age of subjects was 48.2 (SD of 18.2) and ranged between 14 and 100 years of age. Both males and females were nearly equally distributed with males accounting for 48.3%. Most (77.9%) of the subjects had an abnormal echocardiographic report; only 332 (22.1%) had a normal study. Diastolic dysfunction (DD) (33.4%), valvular heart disease (18.4%), and left ventricular hypertrophy (LVH) (13.7%) were the most common findings in our hospital. Among patients with DD, Grade 1 dysfunction accounted for the majority (79.8%), of which 41% had associated LVH. Pulmonary hypertension (PH), cardiomyopathy and ischemic heart disease were also not uncommon. Abnormal echocardiographic findings are common in patients referred to our hospital for transthoracic echo. The commonest echocardiographic abnormalities were DD, Valvular heart disease (both rheumatic and calcific valves) and LVH.

Spectrum of cardiac diseases among young and older adults defined by echocardiography at Jakaya Kikwete Cardiac Institute: A prospective cross-sectional study

BACKGROUND

Cardiovascular diseases (CVDs) are a major cause of morbidity and mortality worldwide, with data showing an increasing trend. Previously uncommon, CVDs of lifestyle are now increasing in many Sub-Sahara African (SSA) countries including Tanzania. The study aimed at determining the spectrum and distribution of CVDs among young (< 45 years) and older (≥ 45 years) adults referred for echocardiography at Jakaya Kikwete Cardiac Institute (JKCI).

METHODS

Hospital-based cross sectional study was conducted among adult patients referred for echocardiography at JKCI between July and December 2021. Patient's socio-demographic and clinical characteristics were recorded. CVD diagnoses were made using established diagnostic criterias. Comparisons were done using chi-square test and student's t-test. Multivariable logistic regression analysis was used to determine factors associated with abnormal echocardiography. A significance level was set at p-value < 0.05.

RESULTS

In total 1,050 patients (750 old and 300 young adults) were enrolled. The mean ± SD age was 62.2 ± 10.4 years and 33.5 ± 7.4 years for older and young adults respectively. Hypertension was the commonest indication for echocardiography both in the young (31%) and older (80%) adults. Majority of older adults were found to have abnormal echocardiography (90.7%), while only 44.7% of the young adults had abnormal echocardiography (p < 0.001). For the older adults, the commonest diagnoses were HHD (70.3%), IHD (9.7%), and non-ischemic cardiomyopathy (6.1%) while for young adults, HHD (16.7%), non-ischemic cardiomyopathy (8%), RHD (8%) and MVP (4.3%) were the commonest. The differences in the echocardiographic diagnoses between young and older adults were statistically significant, p < 0.001. Being an older adult, hypertensive, overweight/obese were independently associated with abnormal echocardiography (p < 0.01).

CONCLUSION

Hypertensive heart disease is the most common diagnosis among adult patients referred for echocardiography at JKCI, both in young and older adults. Primary prevention, early detection and treatment of systemic hypertension should be reinforced in order to delay or prevent its complications.

Pattern of Cardiac Diseases and Co-Existing Morbidities Among Newly Registered Cardiac Patients in an Adult Cardiac Referral Clinic of Hawassa University Comprehensive Specialized Hospital, Southern-Ethiopia

Background

Currently, cardiovascular diseases (CVDs) are rising in the world and require great concern because the consequences are not only morbidity and mortality, but also a high economic burden. However, the pattern of CVDs in Ethiopia is not well known. Therefore, this study aimed to describe CVD and co-existing morbidities among newly registered cardiac patients in Hawassa University Comprehensive Specialized Hospital.

Methods

A retrospective cross-sectional study was conducted from January 1 to December 31, 2016 among newly registered cardiac patients in an adult cardiac referral clinic. Records and cardiac referral clinic logbooks were used to collect relevant information using structured checklists.

Results

Of the total 310 records of cardiac patients, 236 were explored and included in the study, while the records of 74 patients were absent in the cards room when tracing and/or incomplete to assess cardiac pattern. Rheumatic heart disease (RHD) was the leading cardiac problem and diagnosed in 70 (29.7%) cases followed by non-ischemic cardiomyopathy (55, 23.3%), ischemic heart disease (41, 17.4%), hypertensive heart disease (29, 12.3%), and cor pulmonale (14, 5.9%). The mean age of RHD patients was 28.7 (±13.1) years. Eighty-two (35%) females and 23 (19.8%) males had RHD, while 69 (29.2%) females and 23 (19.8%) males had non-ischemic cardiomyopathy. The overall rate of mitral stenosis, mitral regurgitation, and aortic regurgitation among patients with RHD were 39 (55.7%), 48 (68.6%), and 26 (37.1%), respectively. Moreover, the overall coexisted morbidity was 81 (34.3%), with a high rate of hypertension alone at 44 (18.6%) followed by hypertension with diabetes at 11 (4.7%).

Conclusion

This study indicated that more than one-third of cardiac patients had at least one of the co-existing morbidities like hypertension, diabetes mellitus, asthma and other diseases. Therefore, careful diagnosis and management of cardiac patients plays an important role to minimize comorbidity-linked complications. Moreover, population-based studies are recommended for better representing and generalization.